early on® redesign update michigan sicc meeting november 16, 2006

Early OnEarly On® ® Redesign UpdateRedesign Update

Michigan SICC MeetingMichigan SICC Meeting

November 16, 2006November 16, 2006

SICC Presentation November 2006SICC Presentation November 2006

Topics To Be AddressedTopics To Be Addressed

Completed ComponentsCompleted Components

Estimated Prevalence ReportEstimated Prevalence Report

Next StepsNext Steps


Completed ComponentsCompleted Components

Causes and Forces – April 2005Causes and Forces – April 2005

Define Eligible Population* November 2005- Define Eligible Population* November 2005-

Fall 2006Fall 2006

Define Results – ECO Center Child and Define Results – ECO Center Child and

Family OutcomesFamily Outcomes

Convene Results Teams – Summer 2005Convene Results Teams – Summer 2005

Estimated Prevalence Estimated Prevalence ReportReport


Concept of prevalenceConcept of prevalence

What is prevalence?What is prevalence?

prev.a.lence, prev.a.lence, nn. The degree to which . The degree to which something occurs or exists. For example, something occurs or exists. For example, the percentage of a population that meets a the percentage of a population that meets a certain definition, or has a certain certain definition, or has a certain diagnosis.diagnosis.


Purpose of Purpose of Early OnEarly On Prevalence Prevalence StudyStudy

Estimate the number of children that could Estimate the number of children that could have a developmental delay and to understand have a developmental delay and to understand the size of the potentially eligible population.the size of the potentially eligible population.

Identify the gap between who is currently Identify the gap between who is currently being served and who could potentially be being served and who could potentially be served.served.

Leverage existing funds and advocate for new Leverage existing funds and advocate for new funding to help fill service gaps and meet funding to help fill service gaps and meet compliance requirements.compliance requirements.


Purpose of Purpose of Early OnEarly On Prevalence Prevalence StudyStudy

Inform the Inform the Early OnEarly On system redesign efforts and system redesign efforts and strengthen connections with the broader early strengthen connections with the broader early childhood system.childhood system.

Support the recommendation that the ECIC use the Support the recommendation that the ECIC use the prevalence study in their work of supporting the prevalence study in their work of supporting the development of comprehensive early childhood development of comprehensive early childhood systems.systems.

Recognize the potential numbers of children who will Recognize the potential numbers of children who will not meet the not meet the Early OnEarly On eligibility criteria and will eligibility criteria and will need to be served through other community need to be served through other community resources.resources.

What percentage of infants What percentage of infants and toddlers participate in and toddlers participate in

Early OnEarly On??


Gogebic-Ontonagon ISD *Gogebic-Ontonagon ISD *

5.48%5.48%

Traverse Bay Area ISD Traverse Bay Area ISD

3.41%3.41%

Kalamazoo Valley ISDKalamazoo Valley ISD

2.16%2.16%

Delta-Schoolcraft ISD *Delta-Schoolcraft ISD *5.41%5.41%

Marquette-Alger ISDMarquette-Alger ISD3.27%3.27%

Newaygo ISDNewaygo ISD2.16%2.16%

Hillsdale County ISD *Hillsdale County ISD *5.32%5.32%

Lapeer County ISDLapeer County ISD3.15%3.15%

St. Joseph County ISDSt. Joseph County ISD2.16%2.16%

Midland County ESAMidland County ESA

4.74%4.74%Berrien County ISDBerrien County ISD

3.00%3.00%Genesee ISDGenesee ISD

2.12%2.12%

Van Buren ISDVan Buren ISD4.36%4.36%

Jackson County ISDJackson County ISD2.84%2.84%

Eastern Upper Peninsula ISDEastern Upper Peninsula ISD2.04%2.04%

Saginaw ISD/ERC *Saginaw ISD/ERC *4.33%4.33%

Shiawassee RESAShiawassee RESA2.78%2.78%

Livingston ESALivingston ESA2.03%2.03%

Monroe County ISDMonroe County ISD4.27%4.27%

Muskegon Area ISDMuskegon Area ISD2.77%2.77%

Macomb ISDMacomb ISD1.91%1.91%

Ionia County ISD *Ionia County ISD *4.25%4.25%

Clinton County RESAClinton County RESA2.75%2.75%

Lenawee ISDLenawee ISD1.83%1.83%

Ingham ISDIngham ISD4.13%4.13%

Calhoun ISDCalhoun ISD2.74%2.74%

Mecosta-Osceola ISDMecosta-Osceola ISD1.74%1.74%

Dickinson-Iron ISDDickinson-Iron ISD4.10%4.10%

Clare-Gladwin ISDClare-Gladwin ISD2.72%2.72%

Tuscola ISDTuscola ISD1.74%1.74%

Ottawa Area ISDOttawa Area ISD4.09%4.09%

COOR ISDCOOR ISD2.70%2.70%

Barry ISDBarry ISD1.69%1.69%

Gratiot-Isabella RESDGratiot-Isabella RESD3.90%3.90%

Sanilac ISDSanilac ISD2.55%2.55%

Washtenaw ISDWashtenaw ISD1.64%1.64%

Lewis Cass ISDLewis Cass ISD3.77%3.77%

Kent County ISDKent County ISD2.49%2.49%

Alpena-Montmorency-Alcona ESDAlpena-Montmorency-Alcona ESD1.60%1.60%

Iosco County ISDIosco County ISD3.77%3.77%

Mason-Lake ISDMason-Lake ISD2.47%2.47%

Huron ISDHuron ISD1.45%1.45%

Allegan County ISDAllegan County ISD3.70%3.70%

Charlevoix-Emmet ISDCharlevoix-Emmet ISD2.39%2.39%

St. Clair County ISDSt. Clair County ISD1.41%1.41%

Montcalm Area ISDMontcalm Area ISD3.65%3.65%

Eaton ISDEaton ISD2.32%2.32%

Oceana ISDOceana ISD1.35%1.35%

Wexford-MissaukeeWexford-Missaukee3.56%3.56%

Copper Country ISDCopper Country ISD2.31%2.31%

Wayne County RESAWayne County RESA0.87%0.87%

Branch ISDBranch ISD3.50%3.50%

Bay-Arenac ISDBay-Arenac ISD2.22%2.22%

Oakland ISDOakland ISD0.85%0.85%

Manistee ISDManistee ISD3.47%3.47%

COP ISDCOP ISD2.21%2.21% State averageState average 2.12%2.12%

Menominee County ISDMenominee County ISD3.47%3.47% Green plus 1 SD from Mean - Yellow minus 1 SD from mean DecemberGreen plus 1 SD from Mean - Yellow minus 1 SD from mean December

December 1, 2004 Child Count, Percentage of Children Served

What percentage of infants What percentage of infants and toddlers participate in and toddlers participate in

Part C nationally?Part C nationally?


Broad Eligibility (N=24)

Hawaii 6.71

Massachusetts 5.90

Wyoming 4.31

West Virginia 4.28 Moderate Eligibility (N=13)

New Mexico 3.73 New York 4.33

Pennsylvania 3.31 Rhode Island 4.09

Vermont 3.20 Indiana 4.04

New Hampshire 2.96 Illinois 3.00 Narrow Eligibility (N=15)

Wisconsin 2.88 Delaware 2.94 Connecticut 3.16

Maryland 2.88 S Dakota 2.91 N Dakota 3.02

Kansas 2.62 Puerto Rico 2.58 Idaho 2.90

Ohio 2.47 New J ersey 2.53 Maine 2.89

Iowa 2.35 Kentucky 2.17 Montana 2.21

Arkansas 2.25 Alaska 2.09 Oklahoma 2.03

Michigan 2.20 Colorado 1.85 Utah 1.87

California 1.99 Minnesota 1.56 S Carolina 1.87

Texas 1.93 Missouri 1.47 Tennessee 1.80

North Carolina 1.85 Oregon 1.78

Florida 1.80 DC 1.68

Washington 1.79 Nebraska 1.67

Louisiana 1.76 Arizona 1.61

Virginia 1.72 Nevada 1.36

Alabama 1.39 Georgia 1.34

Mississippi 1.34 Guam No Data

Virgin Islands No Data

Northern Marianas No Data

American Samoa No Data

Eligiblity categories were established by the Office of Special Education Programs (OSEP) as of October 28, 2005. Source: Table 6-1 www.ideadata.org

IDEA Part C: Percentage of All Children Served, December 1, 2005

= 2.40% national baseline

= birth mandate

= at risk

= Education Lead


MethodologyMethodology

The premise of an estimated prevalence The premise of an estimated prevalence model is rooted in the notion that all model is rooted in the notion that all communitiescommunities within a state Part C system within a state Part C system should serve the same should serve the same percentage of percentage of childrenchildren; ; except forexcept for accounting accounting (indexing)(indexing) for community differences in for community differences in population population characteristicscharacteristics that are likely predictors of that are likely predictors of participation in early intervention.participation in early intervention.


Steps in the prevalence study:Steps in the prevalence study: Define the community for which you are estimating

prevalence (ISDs). Calculate the percentage of children currently in

service in each community. Select a projection model (i.e. population variables

that are predictors of participation in early intervention).

Compute an index. Estimated prevalence projection. Decide how results will play a role in your system. Continue to review, refine and update.


Step 1. Step 1. Define the community for which you are estimating

prevalence

For consistency with the current system, we are For consistency with the current system, we are defining ‘community’ as ISD service areas.defining ‘community’ as ISD service areas.

Some data was only available on a county basis, in Some data was only available on a county basis, in which case we had to combine county data to which case we had to combine county data to approximate ISD service areas.approximate ISD service areas.


Step 2. Step 2. Calculate the percentage of children currently in

service in each community

Determine the number of children in service at a Determine the number of children in service at a given point in time (‘shapshot’ count).given point in time (‘shapshot’ count).

Divide by the total number of children in the birth-3 Divide by the total number of children in the birth-3 age group (‘birth cohort’).age group (‘birth cohort’).

Result is your percentage of children currently in Result is your percentage of children currently in service.service.


Step 3. Step 3. SeSelect a projection model

The projection model is made up of population variables that are predictors of participation in early intervention, typically social risk factors or health risk factors.

There should be evidence of a link between the population variable and early intervention (e.g. through epidemiological studies, National Early Intervention Longitudinal Study, identified in IDEA as a target population, etc.)


Step 3. Step 3. REQUIRED Data Characteristics!

1. Data must be readily available;

2. Must be population-based data rather than participatory counts (e.g. birth certificate data, Census data);

3. Must have a long history of consistent data collection;

4. The data must be statistically reliable;

5. The data must be available as both numbers and rates; and

6. The data must be available for the state and county/ISD.


Step 3. Step 3. Population variables considered

Michigan Natality statistics

% of births to teen parents

% of births to women with < high school education

% of births to women >35

% of births to women who smoked

% of births to unmarried women

% of births that were low birthweight (< 2500g)

% of births that were very low birthweight (< 1500g)

% of births that were preterm (<37 weeks)

Rate/1000 for infant mortality



CPS data % population aged 0-4

# of substantiated abuse/neglect CPS cases (meeting CAPTA criteria)

Rate/1000 of substantiated CPS cases

Rank for rate of CPS cases



Other descriptive data Rate/1000 of live births with reported birth defects

% of 0-18 year olds insured by Medicaid

% of 0-18 year olds insured by MIChild (SCHIP)

% of children aged 0-17 living in poverty



Ethnicity % White

% Black or African American

% Native American/Alaskan

% Asian

% Hawaiian/Pacific Islander

% of Hispanic/Latino origin


Step 3. Step 3. Population variables chosen

Poverty Source: Bureau of the Census, Small Area Income Estimates; Poverty rate children 0-17 (2002)

Low Birthweight (< 2500 grams)

Natality statistics from Michigan 2003 resident birth files

Mother < High School education at time of child’s birth

Natality statistics from Michigan 2003 resident birth files

Birth Defects Birth Defects Cases among Resident Live Births - Cases Diagnosed within 1 year of Birth by Residence County and Birth Year; Michigan Resident Birth Cohorts - 1999 through 2002

Preterm birth (< 37 weeks) Natality statistics from Michigan 2003 resident birth files

Race (non-white population)

Ethnicity - US Census 2000(http://factfinder.census.gov/servlet/GCTTable?_bm=n&_lang=en&mt_name=DEC_2000_PL_U_GCTPL_ST2&format=ST-2&_box_head_nbr=GCT-PL&ds_name=DEC_2000_PL_U&geo_id=04000US26)


Step 3. Step 3. Population variables chosen, cont.

Poverty Index 2002

Low Birth Weight 2003

<12 YrsEducation

2003

Birth Defects99-02

Preterm Birth 2003

Race/Ethnicity

2000

State of Michigan 14.2% 8.2% 16.90% 6.3% 11.20% 19.85%


Step 3. Step 3. SMALL GROUP WORKSMALL GROUP WORK

Review Review Population data for your community

• Use Worksheet 1, and Table 1 from your LICC’s Data folder.

• Take about 15 minutes to review the questions on Worksheet 1 with your LICC members.


Step 4. Step 4. Compute an index

• The ‘Index’ is the number that accounts for community differences.

• Divide the percent of children in service by the sum of the population variables chosen for the model.

• The highest resulting number from across the communities will be the index that will be applied universally.

• It is important to verify that the index community has a reliable and valid percent of children in service, is using the state definition of eligibility, is using an eligibility determination process that is in compliance with rules and regulations, and their data represents an established pattern of service.


Step 5. Step 5. Estimated prevalence projection

Sum

12-1-2004 Child Count % in service Index

Universal(State)Index

Estimated Prevalence Percentage

State of Michigan 76.7% 2.12% 0.0276 0.101496 7.8%


Step 6.Step 6.How will Michigan use the results of the How will Michigan use the results of the Early OnEarly On

prevalence study?prevalence study?

Estimate the number of children that could have a Estimate the number of children that could have a developmental delay and to understand the size of the developmental delay and to understand the size of the potentially eligible population.potentially eligible population.

Identify the gap between who is currently being served Identify the gap between who is currently being served and who could potentially be served.and who could potentially be served.

Leverage existing funds and advocate for new funding Leverage existing funds and advocate for new funding to help fill service gaps and meet compliance to help fill service gaps and meet compliance requirements.requirements.


Step 6.Step 6.How will Michigan use the results of the How will Michigan use the results of the Early OnEarly On

prevalence study?prevalence study?

Inform the Inform the Early OnEarly On system redesign efforts and system redesign efforts and strengthen connections with the broader early strengthen connections with the broader early childhood system.childhood system.

Support the recommendation that the ECIC use the Support the recommendation that the ECIC use the prevalence study in their work of supporting the prevalence study in their work of supporting the development of comprehensive early childhood development of comprehensive early childhood systems.systems.

Recognize the potential numbers of children who will Recognize the potential numbers of children who will not meet the not meet the Early OnEarly On eligibility criteria and will need eligibility criteria and will need to be served through other early childhood community to be served through other early childhood community resources.resources.



Completion of Cost StudyCompletion of Cost Study Development of Purchasing PlanDevelopment of Purchasing Plan

Triangulate:Triangulate: Causes and ForcesCauses and Forces Results Teams’ RecommendationsResults Teams’ Recommendations Revenue InformationRevenue Information

Allocate ResourcesAllocate Resources Development of Interagency AgreementDevelopment of Interagency Agreement Final Report in FebruaryFinal Report in February

early on® redesign update michigan sicc meeting november 16, 2006

Documents

jackson county isd2

kent county isd2

joseph county isd2

genesee isd2

coor isd2

ton isd2

sanilac isd2

cop isd2